Diabetes and mental health

Position statement

Psychological issues related to the diagnosis and/or self-care demands of diabetes often have a negative effect on many aspects of diabetes management and glycemic control. As such:

individuals with diabetes should be regularly screened by their healthcare team for psychological distress and psychiatric disorders (1);
access to mental health professionals and community support should be timely, affordable and ongoing; and
diabetes self-management education should incorporate strategies to prevent and/or manage psychological distress related to the diagnosis and management of diabetes.

Definitions

Psychological distress is a term that includes a range of negative feelings and emotions that people experience in reaction to adversity. Ongoing or persistent negative moods such as sadness, frustration and anxiety can be mild or severe and may affect quality of life.

Psychiatric disorders are mental illnesses which may include conditions such as major depression, severe anxiety and eating disorders. Unmanaged psychological distress may trigger or worsen existing psychiatric conditions.

Background and rationale

People with diabetes are often overwhelmed or frustrated by the burdensome demands of managing their chronic disease. They may feel angry, guilty, frightened, discouraged, depressed and unmotivated and their relationships may be strained.

People with diabetes are at greater risk of mental illness and people with some mental illnesses are at greater risk of diabetes. Depression is more common in people with diabetes compared to the general population and major depression is present in approximately 15% of people with diabetes (2).

Depression is associated with poorer self-care, poorer blood glucose control, health complications, decreased quality of life and psychological well being, increased family problems and higher health care costs. It is important that physicians and other members of the diabetes healthcare team consider or address the psychological aspects of living with diabetes.

Diabetes self-management education and follow-up is vital to understanding and managing diabetes, thereby helping to reduce psychological stress related to the diagnosis and management of diabetes. However, long waiting lists at diabetes clinics and poor access in rural areas are often barriers to accessing required education and ongoing support.